The future of NHS Estates and Facilities

Enhancing clinical service delivery to free up patient flow can only be achieved with the right infrastructure and support from an effective Estates and Facilities function. Safety and age are real challenges for the Acute estate, especially with significant recent increases in the NHS maintenance backlog and high-risk backlog of 11% and 14% respectively.  

Identifying where estates and infrastructure failure disrupts clinical practice and investing capital wisely can create short-term fixes. In the latest ERIC data return, clinical service incidents because of infrastructure failure fell by 22%. However, long-term solutions will require greater levels of sustained investment in the estate and the teams who manage it.  

Working collaboratively to deliver improvements

During the pandemic there was an urgent need for NHS teams and their supply chain to work collaboratively to tackle some of the most pressing issues they’d ever faced - including oxygen safety, infection prevention and control, space reconfiguration, as well as the construction and operationalisation of the Nightingale hospitals.  

It demonstrated the breadth of expertise available to the NHS and what can be achieved collectively, as Simon highlights, ‘it was a very proud moment for myself and the team to see how both the in-house and out-house estates and facilities community came together and really drove to a common purpose, which was really fulfilling to see.’  

As recognised in the Government’s outsourcing playbook, identifying where capacity and capabilities are, and selecting the most appropriate solution, can add resilience, help maintain costs, improve access to capital and drive innovation.

Developing the workforce

The EFM workforce is core to how the estates and facilities operation supports clinical practice and better patient throughput. Accounting for almost 8% of the NHS workforce, there are c.100k people working across Estates and Facilities and its supply chain. Building, developing and engaging these people is required to foster a diverse, high-performing and future proofed workforce – all recognised and addressed in the Estates and Facilities Workforce Action Plan. 

Developing a workforce action plan, rather than a strategy, has been key to NHS England’s success in the first year since its publication. Simon highlights several key initiatives already in progress while calling out areas for further development ‘There are some green shoots, and it’s definitely working effectively… at this point, I’m happy in the way that we’re seeing things progress.’  

Equality, diversity and inclusion is one of the four EFM priorities outlined in the plan and an area Simon recognises needs more work ‘we’ve also still got quite a lot of work to do around diversity, particularly at senior level, and we’re working with estates directors and other senior managers about how we can do that.’

Future priorities for NHS EFM

Despite having several significant challenges to address, estates and facilities teams are also presented with notable opportunities, making it an exciting time to work for, and partner with, NHS EFM teams.  

Future priorities are categorised by Simon into three distinct areas:  

1. Capital: Robust 5–10-year ICS capital plans, a steady increase in CDEL capital limits, and stabilising several programmes, such as the new hospital programme, are all highlighted as a priority.  
2. Operational: An improved patient and staff experience and insight and compliance around infrastructure failure will be focus themes. 
3. Workforce: To make the NHS the employer of choice. As Simon explains ‘a truly diverse and energetic workforce would be fantastic, and not the recruitment gap we’ve got at the moment.’ 

Discover more about how NHS England is addressing some of the EFM challenges it faces while maximising the opportunities to deliver a more compliant, robust estate which enhances clinical delivery.

Image: Romford Recorder and Ellie Hoskins www.elliehoskins.com